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MANCHESTER — On Aug. 21, 2008, Kevin McEvoy readily told the staff at Valley Street jail that he was a heroin user when he entered the jail following his arrest for receiving stolen property.

Besides the needle marks on his arms, he was high and exhibiting signs of withdrawal, according to medical screening forms that day. He got sick, and guards who dealt with McEvoy noted he was weak, nauseated and "did not look good."

Four days later, he was dead, found in a cell. An autopsy determined McEvoy had died of severe dehydration and kidney failure.

His parents sued the jail. The county's insurer settled and paid $415,000 to the McEvoys in 2011.

In a stinging review of McEvoy's death, a consultant noted that Valley Street jail personnel should have better monitored McEvoy and hospitalized him when dehydration set in. The consultant also faulted the county for not having a standard for heroin withdrawal, although it did for alcohol withdrawal.

"The problem with that particular case was the failure of the system," said Dr. Charles Ward, the former jail physician who said he was fired from his job three years ago on an unrelated case.

Many correction facilities use prescription medicine to lessen withdrawal symptoms, and they use an 11-item scale to assess withdrawal, wrote the consultant, Jacqueline Moore of Colorado, who was hired by the lawyers of McEvoy's estate.

But Ward had his own list of medicines for withdrawal — Maalox, Tylenol and Kaopectate, the consultant wrote.

Ward admitted during his deposition that he did not know correctional industry standards for inmate health care and had never read the manuals, Moore wrote.

"Dr. Ward did not develop adequate procedures for detoxification and monitoring of inmates. He expected the inmates to quit 'cold turkey,'" Moore wrote.

In its replies to the McEvoy lawsuit, county officials said they relied on Ward's expertise, that they have immunity as government officials, and that McEvoy was in "self-imposed" poor health as a heroin addict and someone with a history of heart and mental-health issues.

In an interview, Jail Superintendent David Dionne said the jail has now developed a standard for inmates withdrawing from heroin. He said McEvoy was in trouble medically when he arrived.

"We were behind the eight-ball," Dionne said.

In her review, Moore faulted jail nurses for placing McEvoy in the general population, for incomplete examinations, and for not sending him to the hospital when they knew he was dehydrated. Although the nurses claimed in depositions that they took his vital signs, none were recorded.

In the last six years, the county has also settled two other death-related suits.

In 2011, it paid $15,000 to the estate of Edward Caldwell, who died in a Massachusetts hospital shortly after his release from Valley Street Jail in 2008. A drug addict, Caldwell had a complicated medical history with jail and hospital officials; he died of a drug overdose in the Massachusetts hospital, after an unidentified person injected him with drugs.

In 2008, the county paid $24,000 to the estate of Dana Vath, after he was found hanging in his cell six years earlier. In lawsuits, the estate claimed he had been beaten in his cell by corrections officers.